Author(s): Kate Kwiatkowski, Bob Arnold, David Barnard

Physicians are commonly asked to pray for a patient or to lead a patient/family in prayer. The physician may feel conflicted because of uncertainty--how to be supportive to the patient, respect professional/personal boundaries and remain true to his/her own religious beliefs. The following options attempt to respect the integrity of the physician's spiritual/religious beliefs and be supportive of the patient's emotional needs.

Options:

1. Pray with/for the patient: It is entirely appropriate for physicians to pray if they feel comfortable doing so and such prayer is consistent with their own spirituality. (see pitfalls)
2. Sit with patient while patient prays: A physician who is uncomfortable praying with/for the patient may choose instead to sit quietly in supportive company while the patient prays. In this way, physicians lend support to the patient and his/her spiritual beliefs without explicitly endorsing a particular belief system themselves.
3. Respectfully decline: Physicians who are uncomfortable with either of the above options may respectfully decline to pray with/for the patient. To avoid the patient feeling rejected, the physician may want to say: I am really sorry, I am not comfortable with that {eg leading a prayer].. In such cases, physicians are encouraged to make non-religious supportive comments: You will be in my thoughts. Note: patients who ask for prayers may have unmet spiritual needs. A hospital chaplain can assist patients talk or reflect upon their spiritual issues. The physician should ask the patient about referral: Would you like to visit with the hospital chaplain or Would it be helpful for the hospital chaplain come and spend some time with you?

1. It is inappropriate for the physician to impose his/her religious beliefs on the patient or to offer prayer in a manner that is not respectful of the patient?s beliefs. Given the differences in beliefs and practices, even within specific denominations, non-denominational prayer is safest. For example, rather than referring to Jesus, Budda or Allah, use a more neutral and inclusive term like God. Asking God for support or that God?s will be done is safer than asking for specific outcomes, particularly if you think the patient is dying.
2. A physician should not promise to pray for a patient if s/he has no intention of doing so. This has the potential to undermine trust in the physician-patient relationship.

References:

1. Cohen, C. et al. Prayer as Therapy: A Challenge to Both Religious Belief and Professional Ethics. Hastings Center Report. May-June 2000.
2. Walking a Fine Line: Physician Inquiries into Patients? Religious and Spiritual Beliefs. Hastings Center Report. September-October 2001.
3. Lo, B. et al. Discussing Religious and Spiritual Issues at the End of Life: a Practical Guide for Physicians. JAMA. 287:6, 2002.
4. Responding to Requests Regarding Prayer and Religious Ceremonies by Patients Near the End of Life and Their Families. Palliative Medicine. 6:3, 2003.

Copyright/Referencing Information: Users are free to download and distribute Fast Facts for educational purposes only. Citation for referencing: Kwiatkowski K, Arnold R and Barnard D. Fast Facts and Concepts #120: Physicians and prayer requests. September 2004. End-of-Life/Palliative Education Resource Center www.eperc.mcw.edu.

Fast Facts were edited by David Weissman MD, Palliative Care Center, Medical College of Wisconsin until January 2007.  For comments/questions write to the current editor, Drew Rosielle MD: drosiell@mcw.edu. The complete set of Fast Facts is available at EPERC: www.eperc.mcw.edu

Purpose: Instructional Aid, Self-Study Guide, Teaching

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